Music is Medicine, with Elizabeth Nightingale
"Music can do far more than you think." - Elizabeth Nightingale
In this episode, Ben and Patrick explore the transformative power of music therapy, particularly neurologic music therapy (NMT), in rehabilitation. Elizabeth Nightingale, a neurologic music therapist, shares her insights on how music can facilitate cognitive, emotional, and physical healing. The conversation delves into various techniques used in NMT, the neuroscience behind music's impact on the brain, and the importance of integrating music therapy within multidisciplinary teams. Elizabeth emphasises the significance of personalising music therapy to each client's unique experiences and cultural backgrounds, highlighting its role in fostering connections and enhancing overall wellbeing.
Neurologic Music Therapy represents a powerful intersection of neuroscience, rehabilitation, and the universal human connection to music. As Elizabeth Nightingale eloquently demonstrates throughout this conversation, NMT is not simply about playing music for patients—it's a sophisticated, evidence-based approach that strategically engages neural pathways to achieve specific functional outcomes.
What makes NMT particularly valuable in rehabilitation is its dual nature: it provides rigorous, measurable therapeutic benefits while simultaneously offering an engaging, motivating, and emotionally meaningful experience for clients. This combination addresses both the neurological and psychological aspects of recovery, creating a holistic approach that can complement and enhance traditional rehabilitation methods.
So what? For rehabilitation professionals, this episode highlights the importance of considering music therapy not as an optional add-on but as a potential core component of comprehensive rehabilitation plans. For individuals and families navigating recovery from neurological conditions, it offers hope that there are innovative, enjoyable approaches that can unlock progress when traditional methods alone may be insufficient. As Elizabeth concludes, "Music can do far more than you think it might do"—a powerful reminder to explore all available pathways to healing and connection.
Key Insights
Neurologic Music Therapy (NMT) is a system of 20 standardized clinical techniques based on neuroscience research about how the brain responds to music.
Music activates multiple areas of the brain simultaneously, allowing therapists to target specific neural pathways for rehabilitation purposes.
NMT can be used to improve speech and language functions even when traditional language centers are damaged, by utilizing intact parts of the brain through musical activities.
The approach can help patients with physical rehabilitation, using rhythmic entrainment to improve movement coordination, gait, and fine motor skills.
Music therapy engages patients more effectively than some traditional therapies because it is enjoyable and often taps into preserved abilities, creating success experiences that build confidence.
NMT is most effective when integrated with other rehabilitation disciplines like occupational therapy, physiotherapy, and speech therapy in a comprehensive approach.
Cultural and personal musical preferences are important considerations in treatment planning, making therapy more meaningful and effective for each individual.
About Elizabeth
Elizabeth is an experienced Neurologic Music Therapist, bringing over ten years of specialist clinical practice within acute, inpatient, and community neurorehabilitation. She has worked with both children and adults across a wide range of settings, and has expertise in acquired brain injury, cerebral palsy, disorders of consciousness, and aphasia. She is a registered Neurologic Music Therapy® Fellow affiliate of the Academy of Neurologic Music Therapy® and is trained in the Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC). Since 2018, Elizabeth has worked as an Expert Witness, drawing on her wide-ranging clinical experience to identify and cost appropriate NMT provision and specialist equipment for children and adults with neurological diagnoses. Alongside her clinical work, she actively contributes to the profession through several voluntary roles, including positions on the NMT™ Academy Advisory Council, Acquired Brain Injury London, and as Learning Disability Network Coordinator for the British Association for Music Therapy (BAMT).
Elizabeth’s work has been recognised nationally, including as the first UK therapist to deliver Neurologic Music Therapy® within a digital Intensive Comprehensive Aphasia Programme, bringing high-intensity stroke and aphasia rehabilitation directly into people’s homes. Alongside her clinical and medico-legal work, she is passionate about sharing knowledge and actively trains allied health professionals through online courses, supporting integrated, collaborative care. Her approach is rooted in person- and family-centred practice, with a strong focus on empowering caregivers through practical, accessible support. In 2025, Elizabeth completed the Cardiff University Bond Solon Civil Expert Witness Certificate and was shortlisted for a Neuro Rehab Times ‘Inspirational Contribution’ award in recognition of the reach and impact of her work.
A few key links:
Neurologic Music Therapy® website for those interested to learn more about NMT™, the research base, and training options: www.nmtacademy.co
Music and the Brain visual: https://www.merriammusic.com/research/the-neuro-plastic-side-of-melodies-how-music-rewires-the-brains-cognitive-sockets/
Example video of NMT™ sensorimotor techniques in action for a patient who sustained a TBI: https://youtu.be/cq8fv3Hpoao?si=gWmgnB0I8yeNQ_dr
Nightingale NMT™ website: www.nightingalenmt.co.uk
Nightingale NMT™ instagram: https://www.instagram.com/nightingalenmt/
Connect with Elizabeth on LinkedIn: https://www.linkedin.com/in/elizabeth-nightingale-%F0%9F%A7%A0%F0%9F%8E%B6-a0696321/
NMT™ at the heart of rehab visual: https://www.instagram.com/p/DReX9bNDXoG/?igsh=MW83a3R1a3JuNmRweA==
Guest
Elizabeth Nightingale, Neurologic Music Therapist, Nightingale NMT
© 2025 Patrick Boyd & Dr Ben Marram. All rights reserved.
Understanding Mental Capacity, with Dr Oli Bekarma and Eleanor Tallon
In this episode, Patrick and Ben explore the complexities of the Mental Capacity Act (UK) and its implications for rehabilitation and recovery, with guests Dr Oli Bekarma and Eleanor Tallon.
They discuss the principles of the Act, the role of professionals in assessing capacity, and the impact of emotions on decision-making. The conversation emphasizes the importance of understanding mental capacity as decision-specific and context-dependent, while also addressing the challenges faced by practitioners in this field.
Key Insights
Mental capacity is decision-specific, not a general state, meaning someone may have capacity for one decision but not another.
The Mental Capacity Act is built on five key principles, including the presumption of capacity and the right to make unwise decisions.
Assessment of capacity involves both a functional test (understanding, retaining, weighing, communicating) and a diagnostic test (impairment of mind or brain).
Executive dysfunction can create a disconnect between what someone says they'll do and their actual behavior, complicating capacity assessment.
Emotions, anxiety, and context significantly impact decision-making capacity and must be considered during assessments.
Building rapport and creating a comfortable environment for the person being assessed is crucial to getting accurate results.
Mental capacity assessment is not binary but exists on a spectrum, requiring professionals to consider scaffolded support rather than all-or-nothing approaches.
The Mental Capacity Act provides a crucial framework for supporting individuals with decision-making challenges while respecting their autonomy and rights. This discussion highlights that proper implementation requires moving beyond simplistic, binary views of capacity toward nuanced, person-centered approaches that recognize capacity as decision-specific and context-dependent.
Professionals conducting capacity assessments face significant challenges in balancing risk management with respect for autonomy, managing their own biases, and applying complex legal frameworks to unique individual circumstances. The experts emphasize that best practice involves thorough information gathering from multiple sources, creating comfortable assessment environments, and focusing on supporting decision-making whenever possible rather than simply taking control.
So what? Understanding mental capacity properly matters because it directly impacts people's fundamental rights to self-determination and dignity. Poor assessment practices can unnecessarily restrict people's freedoms, while overly cautious approaches might leave vulnerable individuals without needed support. By approaching capacity as specific to each decision, focusing on abilities rather than just deficits, and providing appropriate scaffolding, practitioners can help ensure people retain maximum autonomy while receiving necessary protection—striking the delicate balance that respects both liberty and safety.
Unlocking Communication, with Matthew Nakonesky
Matthew Nakonesky, Principal Speech and Language Therapist and founder of Speech Therapy Northeast, joins us to explore cognitive communication disorders and the power of group therapy in brain injury rehabilitation. With over two decades of experience, Matthew shares how cognitive impairments, such as memory loss and slowed processing, affect communication across every aspect of life.
He emphasises that therapy must extend beyond the clinic, adapting to real world environments where communication is spontaneous and context driven. From helping a client detect sarcasm while rock climbing to using soap opera clips to teach social cues, Matthew’s approach blends structured learning with practical application.
At Speech Therapy Northeast, two types of groups support recovery, one focused on skill development, the other on social connection. These groups offer safe, dynamic spaces for practising communication and receiving peer feedback, which often resonates more deeply than therapist input.
Inspired by Mark Ylvisaker’s philosophy, Matthew incorporates project based therapy, where clients create meaningful resources such as children’s stories and documentaries. These projects foster purpose, identity and community awareness.
Progress is tracked through video analysis and SMART goals, helping clients build confidence and recalibrate self perception. Group dynamics are carefully facilitated, with rotating leadership roles and space for authentic interaction.
This episode highlights how recovery is not just about regaining skills, it is about rediscovering purpose and connection through meaningful, community based care.
Hope Is Foundational, with Vicki Gilman
Join us for a truly deep and reflective dive into the heart of neurorehabilitation with Vicki Gilman, a leading thinker in the field. This conversation goes far beyond the typical clinical discussion, exploring the nuanced and often challenging journey of recovery. Vicki invites us to rethink what rehabilitation truly means, suggesting that it's a continuous, 24 hour process seamlessly woven into the tapestry of everyday life. She challenges the traditional view that limits recovery to the clinical setting, urging us to see the bigger picture of a life being rebuilt.
At the core of this powerful discussion is the concept of hope. Vicki fundamentally asserts that hope is foundational—a vital source of energy and meaning. It is not a fragile, unrealistic emotion to be carefully 'managed' by professionals. She reminds us that for clients facing difficult and lengthy recoveries, this deep seated belief is what fuels their steps forward. Crucially, this optimism must be supported by empowerment. We explore the essential need to give clients genuine choice and control, honoring their priorities even when they diverge from professional expectations. It is in this balance of trust and autonomy that true progress is forged, supported by the cornerstones of communication and trust within multidisciplinary teams.
The dialogue also turns toward the future, examining how technology is reshaping modern practice. While remote delivery and new measurement tools offer exciting possibilities, Vicki cautions that innovation must be thoughtful. Technology must serve the client's recovery; it cannot simply be adopted as a means to cut costs. Ultimately, Vicki leaves us with a profound understanding that rehabilitation resists easy definition. It is a highly individual journey without a clear endpoint. This insightful episode is a must listen for anyone seeking a warmer, more human perspective on recovery, personal resilience, and the enduring power of hope.
Key Insights
Rehabilitation is a continuous, 24-hour process that should blend seamlessly with everyday life rather than being confined to clinical sessions.
Hope is foundational to rehabilitation and should be nurtured rather than dismissed as 'unrealistic,' as it provides energy, meaning, and direction during difficult recovery journeys.
Client empowerment through choice and control is essential, even when those choices might seem unwise, as autonomy must be balanced with protection.
Communication and trust within multidisciplinary teams (MDTs) are more crucial than technical skills for successful rehabilitation outcomes.
Rehabilitation has no definitive endpoint; it's a continuum that evolves with a person's life stages and changing needs.
Outcome measurement is vital to provide objective evidence of progress and guide ongoing rehabilitation efforts.
Technology offers new opportunities for rehabilitation, but must be implemented thoughtfully rather than simply as a cost-saving measure.
This conversation reveals rehabilitation as a deeply human process that transcends clinical interventions to become interwoven with daily life and ongoing personal development. While technical skills and structured approaches remain important, the most fundamental elements — hope, communication, autonomy, and trust — are the true foundations upon which successful rehabilitation is built.
Vicki's perspectives challenge conventional limitations placed on rehabilitation potential, suggesting that artificial endpoints often reflect system constraints rather than true human capacity for growth and adaptation. As technology continues to transform rehabilitation practices, the field faces both opportunity and risk: the potential to enhance measurement, increase therapeutic intensity, and expand access must be balanced against the danger of depersonalizing care or prioritizing cost savings over human connection.
So what? For professionals, this calls for constant reflection on whether practices are truly serving client-defined goals or merely fitting within system parameters. For clients and families, it offers permission to maintain hope and advocate for continued support beyond artificial endpoints. And for healthcare systems, it challenges the assumption that rehabilitation can be neatly packaged with predictable outcomes, suggesting instead that true effectiveness requires flexibility, continuity, and profound respect for individual autonomy and potential.